Ganesh Shankar
Department of ENT Saveetha medical College and hospital, SIMATS University, Kancheepuram, 602105 India.
Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):4222-4229. doi: 10.1007/s12070-024-04819-0. Epub 2024 Jun 19.
To study the involvement of various facial bones in mucormycosis patients. 50 Mucormycosis patients were included in the study after getting their consent from a tertiary care center in Chennai. 50 mucormycosis patients were included from a tertiary care centre in Tamilnadu.The details regarding their symptoms-onset, duration and progression, associated comorbidities were noted.The involvement of various facial bones were assessed by CT paranasal sinuses/CT facial bones and MRI brain with orbit with contrast. Among the study population, the nasal cavity and maxillary sinuses were affected first. In patients who are presenting late, this infection spreads to the base of skull through blood vessels and presents as rhino-orbito-cerebral form.Patients presenting late had high chances of bony erosion.Maxillary osteomyelitis and necrosis has been observed commonly.22 patients had facial bone involvement in this study and they needed thorough wound debridement with removal of the necrosed bone. Mucormycosis is often accompanied by a poor prognosis and a high mortality rate. Hence, aggressive surgical intervention with antifungal therapy is usually necessary. Early diagnosis and prompt treatment can reduce the mortality and morbidity of this lethal fungal infection.
为研究毛霉菌病患者中各种面骨的受累情况。在获得钦奈一家三级护理中心的50名毛霉菌病患者同意后,将他们纳入研究。50名毛霉菌病患者来自泰米尔纳德邦的一家三级护理中心。记录了他们的症状发作、持续时间和进展、相关合并症的详细情况。通过鼻窦CT/面部CT骨扫描以及眼眶增强磁共振脑成像评估各种面骨的受累情况。在研究人群中,鼻腔和上颌窦首先受到影响。对于就诊较晚的患者,这种感染通过血管扩散至颅底,表现为鼻眶脑型。就诊较晚的患者发生骨质侵蚀的几率较高。上颌骨骨髓炎和坏死较为常见。本研究中有22例患者出现面骨受累,他们需要彻底清创伤口并清除坏死骨。毛霉菌病通常预后较差且死亡率较高。因此,通常需要积极的手术干预及抗真菌治疗。早期诊断和及时治疗可降低这种致命真菌感染的死亡率和发病率。